scholarly journals Co-Design of an Evidenced Informed Service Model of Integrated Palliative Care for Persons Living with Severe Mental Illness: A Qualitative Exploratory Study

Healthcare ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1710
Author(s):  
Marianne Tinkler ◽  
Joanne Reid ◽  
Kevin Brazil
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Palliative Care ◽  
Severe Mental Illness ◽  
Palliative Care Service ◽  
Current Evidence ◽  
Study Phase ◽  
Service Model ◽  
Care Needs ◽  
Palliative Care Needs

Background: Globally, close to one billion people are living with a mental health disorder, and it is one of the most neglected areas in Public Health. People with severe mental illness have greater mortality risk than the general population, experience health care inequalities throughout life and represent a vulnerable, under-served and under-treated population, who have been overlooked in health inequality research to date. There is currently a dearth of evidence in relation to understanding the palliative care needs of people with severe mental illness and how future care delivery can be designed to both recognise and respond to those needs. This study aims to co-design an evidenced informed service model of integrated palliative care for persons living with a severe mental illness. Methods: This qualitative sequential study underpinned by interpretivism will have six phases. An expert reference group will be established in Phase 1, to inform all stages of this study. Phase 2 will include a systematic literature review to synthesise current evidence in relation to palliative care service provision for people with severe mental illness. In Phase 3, qualitative interviews will be undertaken with both, patients who have a severe mental illness and in receipt of palliative care (n = 13), and bereaved caregivers of people who have died 6–18 months previously with a diagnosis of severe mental illness (n = 13), across two recruitment sties in the United Kingdom. Focus groups (n = 4) with both mental health and palliative care multidisciplinary staff will be undertaken across the two recruitment sites in Phase 4. Phase 5 will involve the co-design of a service model of integrated palliative care for persons living with severe mental illness. Phase 6 will develop practice recommendations for this client cohort. Discussion: Palliative care needs to be available at all levels of care systems; it is estimated that, globally, only 14% of patients who need palliative care receive it. Reducing inequalities experienced by people with severe mental illness is embedded in the National Health Service Long Term Plan. Internationally, the gap between those with a mental illness needing care and those with access to care remains considerable. Future policy and practice will benefit from a better understanding of the needs of this client cohort and the development of a co-designed integrated care pathway to facilitate timely access to palliative care for people with a severe mental illness.

The Mind-Body Well-being Initiative: a better lifestyle for people with severe mental illness

2021 ◽  
pp. 103985622097886
Author(s):  
Nikela A Lalley ◽  
Sam H Manger ◽  
Felice Jacka ◽  
Tetyana Rocks ◽  
Anu Ruusunen ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Mental Health Treatment ◽  
Well Being ◽  
Physical And Mental Health ◽  
Care Needs ◽  
Capacity Model ◽  
Mind And Body ◽  
The Mind

Objective: This article aims to describe ‘The Mind-Body Well-being Initiative’, a residential mental health treatment model based on the Lifestyle Medicine paradigm, which comprises a mind and body well-being programme. In people with severe mental illness (SMI), particularly for those experiencing psychotic illness, the physical health and mortality gap is significant with greater presence of chronic disease and a 15–20-year life expectancy gap. Conclusions: Our AIM Self-Capacity model of care attempts to address the physical and mental health care needs for the promotion of our patients’ recovery.

Paediatric pain control

2015 ◽  
Author(s):  
Renée McCulloch ◽  
John Collins
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Health Care Professionals ◽  
Pain Control ◽  
Current Evidence ◽  
Care Needs ◽  
The Past ◽  
Dying Children ◽  
Poor Understanding ◽  
Palliative Care Needs

Our understanding regarding pain in children has grown significantly in the past few decades; however, we still find reluctance to acknowledge and treat pain in children. Many myths prevail, and coupled with poor understanding, can undermine the effective treatment of pain in children. Understandably many health-care professionals are apprehensive and fearful about working with very sick and dying children; perhaps there is a sense of failure for being unable to ‘cure’. However, as pain is one of the most common symptoms in this group of children, relieving pain and distress can be an extremely rewarding experience. This chapter outlines the background and principles of understanding, evaluating, and treating pain in children with palliative care needs. It offers an overview of current evidence and hopes to support health-care professionals working in this challenging discipline.

Palliative Care Needs of People Living in a Newly Established Informal Settlement

2018 ◽  
Vol 20 (2) ◽  
Author(s):  
Martjie De Villiers ◽  
Johanna Elizabeth Maree ◽  
Corrien Van Belkum
Keyword(s):  
Palliative Care ◽  
Informal Settlement ◽  
Palliative Care Service ◽  
Physical Symptoms ◽  
The Body ◽  
Care Needs ◽  
Care Clinic ◽  
Medical Diagnoses ◽  
Common Diagnosis ◽  
Palliative Care Needs

Evidence-based guidance for the delivery of palliative care in Africa is rare. Identifying the palliative care needs of this community could contribute evidence to guide the services provided, and could add to the body of knowledge of palliative care in Africa. Using a retrospective chart review research method, the researchers aimed to describe the palliative care needs of people using a nurse-led palliative care service situated in a newly established, underserved, informal settlement in Tshwane, Gauteng, South Africa. A quantitative inductive content analysis method was used to analyse the data. The sample realised at 48 (n = 48). The ages of patients ranged from 21 to 78 with the median age 47. Nearly half (45.9%) of the patients were functionally illiterate. The records reflected 85 different medical diagnoses and some patients suffered more than one illness. The most common diagnosis was HIV/AIDS (54.2%). Furthermore, records revealed 379 health problems, ranging from 1 to 17 per patient, with an average of 8.1. Most problems were physical symptoms (50.3%; n = 195), while 38.8 per cent (n = 147) were psychosocial problems and 9.8 per cent (n = 37) were spiritual problems. The need for pain relief (89.6%; n = 43) was the greatest, followed by the need for emotional support. Patients suffering from various medical diagnoses used the services of the palliative care clinic. Patients’ care needs revolved around relief from total pain. Therefore, nurses should become aware of the suffering of palliative patients living in resource-poor communities, and through meticulous assessment, identify their main care needs.

scholarly journals The effectiveness of aromatherapy, massage and reflexology in people with palliative care needs: A systematic review

2019 ◽  
Vol 34 (2) ◽  
pp. 179-194 ◽  
Author(s):  
Bridget Candy ◽  
Megan Armstrong ◽  
Kate Flemming ◽  
Nuriye Kupeli ◽  
Patrick Stone ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Palliative Care ◽  
Active Control ◽  
International Standards ◽  
Small Samples ◽  
Current Evidence ◽  
Care Needs ◽  
Palliative Care Needs

Background: Aromatherapy, massage and reflexology are widely used in palliative care. Despite this, there are questions about their suitability for inclusion in clinical guidelines. The need to understand their benefits is a public priority, especially in light of funding pressures. Aim: To synthesise current evidence on the effectiveness of aromatherapy, massage and reflexology in people with palliative care needs. Design: A systematic review of randomised controlled trials (PROSPERO CRD42017081409) was undertaken following international standards including Cochrane guidelines. The quality of trials and their pooled evidence were appraised. Primary outcomes on effect were anxiety, pain and quality-of-life. Data sources: Eight citation databases and three trial registries were searched to June 2018. Results: Twenty-two trials, involving 1956 participants were identified. Compared with a control, four evaluated aromatherapy, eight massage and six reflexology. A further four evaluated massage compared with aromatherapy. Trials were at an unclear risk of bias. Many had small samples. Heterogeneity prevented meta-analysis. In comparison with usual care, another therapy or an active control, evidence on the effectiveness of massage and aromatherapy in reducing anxiety, pain and improving quality-of-life was inconclusive. There was some evidence (low quality) that compared to an active control, reflexology reduced pain. Conclusions: This review identified a relatively large number of trials, but with poor and heterogeneous evidence. New clinical recommendations cannot be made based on current evidence. To help provide more definitive trial findings, it may be useful first to understand more about the best way to measure the effectiveness of these therapies in palliative care.

scholarly journals Palliative Care for People with Severe Persistent Mental Illness: A Review of the Literature

2008 ◽  
Vol 53 (11) ◽  
pp. 725-736 ◽  
Author(s):  
Anne Woods ◽  
Kathleen Willison ◽  
Cindy Kington ◽  
Alan Gavin
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Palliative Care ◽  
Empirical Studies ◽  
Practice Research ◽  
Care Providers ◽  
Care Needs ◽  
Persistent Mental Illness ◽  
Collaborative Ventures ◽  
Research And Education

A systematic overview of the literature on palliative care for people with severe persistent mental illness (SPMI) was conducted to inform clinical practice, research, and education. Empirical studies and nonempirical papers were included. Few empirical studies exist. There is even less information about the palliative care needs of, or the nature of palliative care provided to, people with SPMI. Mental health, primary care, and palliative care providers need to partner with people who have SPMI in developing and providing palliative care. The field of palliative care for people with SPMI is wide open and in need of methodologically sound studies that will help define the issues that exist for this vulnerable population. Recognizing the similarities between mental health and palliative care should lead to collaborative ventures and discussions in an attempt to address common and parallel issues.

scholarly journals What makes palliative care needs “complex”? A multisite sequential explanatory mixed methods study of patients referred for specialist palliative care

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Anne M. Finucane ◽  
Connie Swenson ◽  
John I. MacArtney ◽  
Rachel Perry ◽  
Hazel Lamberton ◽  
...  
Keyword(s):  
Palliative Care ◽  
Focus Groups ◽  
Healthcare Professionals ◽  
Psychological Needs ◽  
Care Providers ◽  
Specialist Palliative Care ◽  
Care Needs ◽  
Complex Needs ◽  
Sequential Explanatory ◽  
Palliative Care Needs

Abstract Background Specialist palliative care (SPC) providers tend to use the term ‘complex’ to refer to the needs of patients who require SPC. However, little is known about complex needs on first referral to a SPC service. We examined which needs are present and sought the perspectives of healthcare professionals on the complexity of need on referral to a hospice service. Methods Multi-site sequential explanatory mixed method study consisting of a case-note review and focus groups with healthcare professionals in four UK hospices. Results Documentation relating to 239 new patient referrals to hospice was reviewed; and focus groups involving 22 healthcare professionals conducted. Most patients had two or more needs documented on referral (96%); and needs were recorded across two or more domains for 62%. Physical needs were recorded for 91% of patients; psychological needs were recorded for 59%. Spiritual needs were rarely documented. Referral forms were considered limited for capturing complex needs. Referrals were perceived to be influenced by the experience and confidence of the referrer and the local resource available to meet palliative care needs directly. Conclusions Complexity was hard to detail or to objectively define on referral documentation alone. It appeared to be a term used to describe patients whom primary or secondary care providers felt needed SPC knowledge or support to meet their needs. Hospices need to provide greater clarity regarding who should be referred, when and for what purpose. Education and training in palliative care for primary care nurses and doctors and hospital clinicians could reduce the need for referral and help ensure that hospices are available to those most in need of SPC input.

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